The devastating impact of neglect on foster children

Psychologist Philip Fisher studies how foster care affects children’s neurobiological and psychological development. He emphasizes the need to move the science forward and to understand all the moving parts — what works for whom and why in the context of the interventions that are developed.

Meeri Kim: An increasing number of children worldwide are being raised in foster care due to a history of maltreatment. Multiple studies have found that these kids are at increased risk for disruptions in emotional and behavioral development. What makes foster children more vulnerable to these negative outcomes?

Philip A. Fisher: When looking at the challenges that foster kids face, people are often focused on the negative effects of being raised in a foster home or the abuse that leads them to be placed there or occurs after they are placed. But one of the first insights that our research revealed to us was the concerning and pervasive impact of neglect.

We had colleagues who were studying kids who were adopted from institutions in developing countries, often referred to as orphanages. The neurodevelopmental profiles of these children — who had been raised in rooms with many cribs and few caregivers — looked very similar to our foster kids. The two populations both had learning difficulties, language difficulties, and alterations in the neurobiology that helps them deal with and respond to stress.

“The great majority of kids in foster care settings are victims of neglect rather than physical abuse, which is often news to people.”

Trauma or difficult experiences in foster homes do not occur consistently across the board — in fact, many children have excellent experiences in foster care. However, the absence of supportive and responsive parenting before they enter care — especially early in life — is ubiquitous for foster children. The great majority of kids in foster care settings are victims of neglect rather than physical abuse, which is often news to people. It’s really this early neglect that sets many children on a challenging course ahead.

MK: What is an example of an early childhood intervention that your lab has tested in foster children?

PF: We’ve come up with a scalable video coaching approach called Filming Interactions to Nurture Development, or FIND, that targets caregivers’ capabilities to improve children’s outcomes. The caregivers could be parents in socially and economically marginalized communities or foster parents. FIND emphasizes the “serve and return” relationship between children and caregivers. Children look, point, or make other efforts to get the caregiver’s attention — the serve — and the adults then return with a response.

With FIND, we film these interactions and show the caregivers brief clips of themselves engaging in the serve-and-return process with the child. By showing people what they’re already doing right, you’re essentially holding up a mirror rather than having to teach them skills they don’t have. It’s incredibly powerful, and such rudimentary and light-touch interventions could be big tipping points for the caregivers to help them become more responsive to kids’ needs.

MK: Your lab looks at the neurobiological mechanisms behind early stressful experiences that then inform the creation of interventions that are tested. How does working on the whole translational process affect your research?

PF: Within experimental research in child development, interventions can have a double purpose of trying to impact social good and also testing theory. At their best, that’s what they accomplish.

“What we really should be doing and have neglected historically is to lay out this causal chain where the intervention targets specific, measurable things.”

Unfortunately, interventions have mostly focused on the outcomes side of things. What do you see at the end of the day? Do you detect any change as a result? And if so, you get really excited, which is understandable because the needs of these kids are so high.

But what we really should be doing and have neglected historically is to lay out this causal chain where the intervention targets specific, measurable things. In the case of FIND, what might an intervention that targets serve and return then lead to in terms of a cascade of changes in underlying maternal brain function and the child’s neurobiology around stress? And how might those changes then lead to better outcomes for mother and child?

If we take that as our approach, then we really have the potential to move the science forward and to understand all the moving parts — what works for whom and why in the context of the interventions that are developed.

Philip A. Fisher is a Philip Knight Endowed Professor of Psychology and Research Scientist at the Prevention Science Institute Center for Translational Neuroscience at the University of Oregon. He is Science Director for the National Forum on Early Childhood Policy and Programs and a Senior Fellow at the Center on the Developing Child, both based at Harvard University. He is also a Senior Fellow at the Oregon Social Learning Center. Dr. Fisher’s work on disadvantaged and maltreated children includes studies to understand the effects of early stress on the developing brain; the development of two-generation prevention and treatment programs to improve high-risk children’s (and their caregiver’s) well-being and brain functioning; and advocacy for science-based policy and practice to improve early learning and healthy development in high-risk children.

The Society for Research in Child Development, a membership association whose mission is to advance developmental science and promote its use to improve human lives, held their 2017 Biennial Meeting in Austin, Texas, April 6 – 8, 2017. The overall theme of the invited program was Developmental Science and Society, although many other areas of research in the field of child development were presented in the general program. For a full list of invited program speakers, visit Invited Program Information or view the entire program using this link: Online Program.